Assessing Mediating Effect of Motivation Types on Competition Intervention For Physically Inactive Adults

Competition has been widely used as the behaviour change technique for physical activity intervention (Peng, Crouse, & Lin, 2012), this approach might push someone motivation to achieve the desired behaviour. Therefore, the objective of this study was to assess the mediating effects of the motivation on the competition intervention effectiveness. An experimental research was conducted where participants were randomly allocated into one of two groups (control and competition group). For calculating the motivation types, Behavioural Regulation in Exercise Questionnaire (BREQ-2) was administered. The results revealed that motivation was not found to mediate the effect of competition intervention

Interventions to reduce consumption of sugar-sweetened beverages or increase water intake: evidence from a systematic review and meta-analysis

A systematic review and meta-analyses were conducted to evaluate the effects of interventions to reduce sugar-sweetened beverages (SSB) or increase water intakes and to examine the impact of behaviour change techniques (BCTs) in consumption patterns. Randomized and nonrandomized controlled trials published after January 1990 and until December 2016 reporting daily changes in intakes of SSB or water in volumetric measurements (mL d¯¹) were included. References were retrieved through searches of electronic databases and quality appraisal followed Cochrane principles. We calculated mean differences (MD) and synthesized data with random-effects models. Forty studies with 16 505 participants were meta-analysed. Interventions significantly decreased consumption of SSB in children by 76 mL d¯¹ (95% confidence interval [CI] −105 to −46; 23 studies, P < 0.01), and in adolescents (−66 mL d¯¹, 95% CI −130 to −2; 5 studies, P = 0.04) but not in adults (−13 mL d¯¹, 95% CI −44 to 18; 12 studies, P = 0.16). Pooled estimates of water intakes were only possible for interventions in children, and results were indicative of increases in water intake (MD +67 mL d¯¹, 95% CI 6 to 128; 7 studies, P = 0.04). For children, there was evidence to suggest that modelling/demonstrating the behaviour helped to reduce SSB intake and that interventions within the home environment had greater effects than school-based interventions. In conclusion, public health interventions – mainly via nutritional education/counselling – are moderately successful at reducing intakes of SSB and increasing water intakes in children. However, on average, only small reductions in SSBs have been achieved by interventions targeting adolescents and adults. Complementary measures may be needed to achieve greater improvements in both dietary behaviours across all age groups

Stress and eating behaviors in children and adolescents: Systematic review and meta-analysis

It is well established that stress is linked to changes in eating behaviors. Research using adult populations has shown that stress is associated with both increases and decreases in the amount and type of food consumed. However, due to a lack of research reviews, the relationship between stress and eating behaviors in children is unclear. This systematic research review and meta-analysis aimed to identify whether stress is associated with healthy and unhealthy eating behaviors in children aged 8-18 years. Studies were included in the review if they measured stress and included a measure of food consumption. All unique studies retrieved (N = 28,070) were assessed for their eligibility at title, abstract and full text levels. A total of 13 studies were included in the final review and data were analysed using Comprehensive Meta-Analysis. Using random-effects modelling, overall stress was not associated with a change in overall eating behaviors. However, additional analyses indicated stress was associated with unhealthy eating behaviors in both younger (Hedge's g = 0.283, p < 0.001) and older (Hedge's g = 0.274, p  = 0.001) children. In contrast, stress was not associated with healthy eating behaviors in younger children (Hedge's g = 0.093, p = 0.156), but was negatively associated with healthy eating behaviors in older children (Hedge's g = -0.384, p < 0.001). The current findings are concerning as they suggest the impact of stress on unhealthy eating may begin as early as 8 or 9 years old. Future research ought to investigate further the role of psychological, behavioral and endocrine factors in the development of stress-related eating in children

Do Electronic Cigarettes Increase Cigarette Smoking in UK Adolescents? Evidence from a 12-month Prospective Study

Background In cross-sectional surveys, increasing numbers of adolescents report using both electronic cigarettes (e-cigarettes) and cigarettes. This study assessed whether adolescent e-cigarette use was associated prospectively with initiation or escalation of cigarette use. Methods Data were from 2836 adolescents (aged 13–14 years at baseline) in 20 schools in England. At baseline, breath carbon monoxide levels, self-reported e-cigarette and cigarette use, sex, age, friends and family smoking, beliefs about cigarette use and percentage receiving free school meals (measure of socioeconomic status) were assessed. At 12-month follow-up, self-reported cigarette use was assessed and validated by breath carbon monoxide levels. Results At baseline, 34.2% of adolescents reported ever using e-cigarettes (16.0% used only e-cigarettes). Baseline ever use of e-cigarettes was strongly associated with subsequent initiation (n=1726; OR 5.38, 95% CI 4.02 to 7.22; controlling for covariates, OR 4.06, 95% CI 2.94 to 5.60) and escalation (n=318; OR 1.91, 95% CI 1.14 to 3.21; controlling for covariates, this effect became non-significant, OR 1.39, 95% CI 0.97 to 1.82) of cigarette use. Conclusions This is the first study to report prospective relationships between ever use of e-cigarettes and initiation and escalation of cigarette use among UK adolescents. Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use. Further research with longer follow-up in a broader age range of adolescents is required

Organizational Barriers to Oral Health Conversations Between Health Visitors and Parents of Children Aged 9–12 Months Old

Background: Dental caries is the most prevalent preventable childhood disease and a major public health priority. Local authorities in England have a statutory responsibility to improve child health, including oral health, through the “Healthy Child Programme.” The “Healthy Child Programme,” which includes the provision of oral health advice is delivered by health visitors to parents of young children. To date, research has mainly concentrated on individual interactions between health visitors and parents, with less attention given to the broader context in which these oral health conversations between health visitor and parents take place. Objective: Our study explored the organizational factors that obstruct health visitors from engaging in meaningful conversations with parents about young children's oral health. Methods: Qualitative interviews and focus groups were held with health visiting teams (n = 18) conducting home visits with parents of 9–12-month olds in a deprived, urban area in England. Results: The study revealed the wide variation in what and how oral health advice is delivered to parents at home visits. Several barriers were identified and grouped into four key themes: (1) Priority of topics discussed in the home visits; (2) Finance cuts and limited resources; (3) Oral health knowledge and skills; and (4) Collaborative working with other professionals. It was evident that organizational factors in current public health policy and service provision play an important role in shaping oral health practices and opportunities for behavior change. Conclusion: Organizational practices and procedures play an important role in creating interaction patterns between health visiting teams and parents of young children. They often limit effective engagement with and positive change in oral health. For future oral health interventions to be effective, awareness of these barriers is essential alongside them being founded on evidence-based advice and underpinned by appropriate theory

Do web-based competitions promote physical activity? Randomized controlled trial

Objectives: Introducing competitions may inspire positive behaviour change but they tend to be implemented alongside other strategies. Thus, the study examined the effectiveness of a competitive web-based intervention to promote physical activity, disentangled the effects of competition from other behaviour change techniques, and identified underlying mediators. Design: Randomized controlled trial. Methods: Physically inactive adults living or working in a UK city (n = 281) were recruited. Participants were randomized to one of three web-based conditions: a control group; a group encouraged to self-monitor their steps and who received basic feedback; a group encouraged to self-monitor their steps who received basic feedback plus additional feedback to instigate competition. Participants’ physical activity was monitored through pedometers for one-week pre-intervention and for four-weeks during the intervention period. Participants completed the BREQ-2 and measures of intention, planning, goal conflict, goal importance, effort, commitment, perceived behavioural control and self-efficacy pre- and post-intervention. Results: Participants in the competition condition increased their steps significantly more than those in the control group with the effect being mediated by increased goal importance, identified motivation and intrinsic motivation. Participants in the competition condition increased their steps more than those in the self-monitoring condition. There was weaker evidence that the self-monitoring group increased their steps more than those in the control condition. Conclusions: Self-monitoring and feedback can increase physical activity but adding a competitive component, implemented via the web, can boost goal importance, identified motivation and intrinsic motivation that mediate these increases in physical activity

A feasibility study to assess the individual and combined effects of financial incentives and monetary contingency contracts on physical activity

Objectives: To assess the feasibility, and demonstrate the preliminary relative efficacy of, individual and/or combined financial incentives interventions for physical activity. Design: Eighty participants were randomised to conditions receiving either: (i)a monetary contingency contract (where individuals deposit money, forfeited or returned depending on goal achievement)plus a standard financial incentive (simple reward upon achievement), (ii)a monetary contingency contract only, (iii)a standard incentive only, or controls groups (iv)with or (v)without a set behavioural goal. Feasibility was investigated through assessment of intervention acceptability, cost-effectiveness, study retention, contamination and missing data. The effects of the interventions on (i)physical activity (daily steps over 2-weeks)and (ii)potential mediators (e.g. intentions)were assessed also. Results: Indicators of feasibility were generally positive, with high acceptability ratings, low drop-out and low missing data. Participants receiving monetary contingency contracts plus standard financial incentives had (i)increased steps above controls (with some evidence of superiority over monetary contingency contract-only participants), (ii)the highest prevalence of goal achievement and cost-effectiveness (being between 57 and 317% cheaper per goal achiever versus other conditions)and (iii)larger deposits than contingency contract-only participants (with some evidence that higher deposits increased steps). There was evidence of contamination between participants, but the results were mostly robust after excluding ‘contaminated’ participants. No differences were observed on psychological mediators. Conclusion: This feasibility trial found promising results for a combined strategy approach to physical activity incentivisation, though a larger confirmatory trial is required

Promoting colorectal cancer screening: a systematic review and meta-analysis of randomised controlled trials of interventions to increase uptake

Colorectal cancer (CRC) represents a global public health concern. CRC screening is associated with significant reductions in CRC incidence and mortality, however, uptake is suboptimal. This systematic review and meta-analysis of randomised controlled trials explored the effectiveness of interventions designed to increase screening uptake, plus the impact of various moderators. Data from 102 studies including 1.94 million participants were analysed. Results showed significant benefit of all interventions combined (OR, 1.49, 95% CI: 1.43, 1.56, p < 0.001). The effects were similar in studies using objective versus self-reported uptake measures and lower in studies judged to be at high risk of bias. Moderator analyses indicated significant effects for aspects of behaviour (effects lower for studies on non-endoscopic procedures), and intervention (effects higher for studies conducted in community settings, in healthcare systems that are not free, and that use reminders, health-professional providers, paper materials supplemented with in-person or phone contact, but avoid remote contact). Interventions that included behaviour change techniques targeting social support (unspecified or practical), instructions or demonstration of the behaviour, and that added objects to the environment produced stronger effects. The way in which findings can inform interventions to improve CRC screening uptake is discussed

Patterns and predictors of e-cigarette, cigarette and dual use uptake in UK adolescents: Evidence from a 24-month prospective study

Background and Aims: To assess prevalence and predictors of e-cigarettes/cigarettes patterns of use in adolescents in England. Design: Prospective study with 24-month follow-up of e-cigarette/cigarette ever/regular use with data from an intervention evaluation. Setting: Forty-five schools in England (Staffordshire and Yorkshire). Participants: 3,210 adolescents who, at baseline, were aged 13-14 years and had never used e-cigarettes/cigarettes. Measurements: Based on e-cigarette/cigarette ever use at follow-up, six groups were created: (a) never user, (b) e-cigarette only, (c) cigarette only, (d) dual use – order of use unclear, (e) dual use – e-cigarettes used first, (f) dual use – cigarettes used first. Baseline measures were: gender, ethnicity, socioeconomic status, impulsivity, family plus friend smoking, and smoking-related beliefs (attitude and perceived behavioural control). Findings: In groups (a) through (f), there were 71·5%, 13·3%, 3·3%, 5·7%, 2·9%, and 3·4% adolescents, respectively. Among groups using cigarettes, regular smoking was more prevalent in group (f) (dual use – cigarettes used first) (17·6%, 95%CI 10·4, 24·8) than in groups (c), (d) and (e) combined (7·3%, 95%CI 4·7, 9·9). Among groups using e-cigarettes, regular use was less prevalent in group (b) (e-cigarette only) (1·9%, 95%CI 0·6, 3·2) than in groups (d), (e) and (f) combined (12·2%, 95%CI 8·9, 15·5). Higher impulsivity plus friends and family smoking were predictive of being in groups (b) to (f) compared with group (a) (never users). Males were more likely to be in group (b) compared to group (a); females were more likely to be in groups (c) to (f) compared to group (a). Conclusions: Regular use of e-cigarettes/cigarettes varies across groups defined by ever use of e-cigarettes/cigarettes. Interventions targeted at tackling impulsivity or adolescents whose friends and family members smoke may represent fruitful avenues for future research

The utility of monetary contingency contracts for weight loss: a systematic review and meta-analysis

Financial incentives to improve health have received increasing attention, but are subject to ethical concerns. Monetary Contingency Contracts (MCCs), which require individuals to deposit money that is refunded contingent on reaching a goal, are a potential alternative strategy. This review evaluates systematically the evidence for weight loss–related MCCs. Randomised controlled trials testing the effect of weight loss–related MCCs were identified in online databases. Random-effects meta-analyses were used to calculate overall effect sizes for weight loss and participant retention. The association between MCC characteristics and weight loss/participant retention effects was calculated using meta-regression. There was a significant small-to-medium effect of MCCs on weight loss during treatment when one outlier study was removed. Group refunds, deposit not paid as lump sum, participants setting their own deposit size and additional behaviour change techniques were associated with greater weight loss during treatment. Post-treatment, there was no significant effect of MCCs on weight loss. There was a significant small-to-medium effect of MCCs on participant retention during treatment. Researcher-set deposits paid as one lump sum, refunds delivered on an all-or-nothing basis and refunds contingent on attendance at classes were associated with greater retention during treatment. Post-treatment, there was no significant effect of MCCs on participant retention. The results support the use of MCCs to promote weight loss and participant retention up to the point that the incentive is removed and identifies the conditions under which MCCs work best